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Positive pregnancy test after after surgical abortion?

Hi Alice,

I had a surgical abortion and then went to get a contraceptive injection (Depo-Provera) two days later. I had unprotected sex on the five days after that. I did a pregnancy test today (about three days after I had sex) and it shows positive. Is it possible that I could be pregnant again? Please help.

Dear Reader,

The short answer to your question is that if you had the Depo-Provera contraceptive shot within five days of your abortion, becoming pregnant even if your partner did not use a condom seems unlikely. According to Planned Parenthood, the shot provides immediate protection if it’s administered within five days of an abortion or miscarriage or within three weeks of giving birth. If the shot was not given in the appropriate time frame or not given at all, it’s certainly possible to get pregnant again after an abortion. For more details about possible pregnancy due to unprotected sex after an abortion, read Can you get pregnant within two weeks of having an abortion? In light of this, an unasked question here might be: Is there a possibility that you might have had a false-positive pregnancy test result following an abortion? The answer is yes and that’s why it’s a good idea to get your health care provider involved to confirm.

Since you received the contraceptive shot in the appropriate time frame following the abortion, why would a pregnancy test still come out positive? Pregnancy tests look for a high level of the hormone human chorionic gonadotropin (HCG). All people (regardless of gender) have some amount of HCG in their bodies — but the levels are usually too low to be picked up by a pregnancy test. Pregnant women release much more HCG, with levels changing as the pregnancy progresses. HCG levels in the body gradually decline in the 60 days following an abortion, so many people who take a pregnancy test within that time frame are likely to test positive — even if they are not in fact pregnant anymore or pregnant again because the levels of HCG are still high enough to be detected from the previous pregnancy. Pregnancy tests that use urine simply check for the existence of HCG above a certain threshold, so this can be especially misleading after an abortion. A blood test can identify both if HCG exists above that threshold and exactly what the level of HCG is, which provides a more full picture of what is happening inside the body.

Going to a clinic to take a pregnancy test — rather than relying on an over-the-counter (OTC) pregnancy test — is recommended and has several advantages:

A series of blood tests can show if the HCG levels are decreasing (as would be expected after an abortion, miscarriage, or giving birth) or increasing (suggesting a new pregnancy).

A pelvic exam can confirm the findings of a blood pregnancy test (both to show the abortion was successful and that a new pregnancy has not started) and also check for any physical complications after an abortion.

Talking with a health care provider during your visit to the clinic is a good way to follow up after the abortion experience and ask any additional questions about pregnancy or pregnancy prevention in the future.

Following up with your health care provider after an abortion is always recommended in order to address any physical and emotional needs you might have. If you have any concerns you may be pregnant again or questions about how to stay protected in the future, making an appointment with her/him is an especially good idea. As an additional note, high levels of HCG can point to different medical conditions besides pregnancy. Men can have their HCG levels checked, too! Only a health care provider can determine what the results may mean.

Hopefully, learning more about how levels of HCG remain elevated post-abortion sheds some light onto what may be happening. Going to see a health care provider is the only way to be absolutely certain you know what’s going on — and to be able to put your mind at ease.